probably because alot of students nowadays spend so much time away from their rotations at "lectures" and other mandantory things. couple this with the fact that alot of students dont have to take call or round with the residents on the weekend....
I would definately agree the structured components are not necessarily ideal. However, I have worked with numerous students. They are bright and very, very adept at using the structured education plan to assure maximal "good time" on each and every rotation.
Residents that I have seen "drop" from a program often cite not knowing "what it was really about". These are the same individuals that I often met in interview and/or reviewed app personal statements proclaiming how much they loved surgery and how "fun" it was...
The problem is, anyone can structure their learning into the most enjoyable components. I see students routinely decide not to attend a case cause, "I already saw that". While it is important to maximize exposure and experience, I have seen few students volunteer for the dis-impaction or rigid sig for volvulus or the nasty hemorrhoid or etc... Instead, there is an exponential expectation of enjoyment for every minor task completed.
If you want to do any specialty, you need to investigate it and arrange to participate in the worst parts of it and especially get a flavor for the bread & butter. Tell the attendings, "I am really interested in this specialty. I don't want the perfect sales pitch. I want the under-belly experience. On this rotation, I would like to experience the bread and butter and the negatives of this field". This goes for pedes/IM/FMOB/surge/Uro/Ortho/Anesth/Psych/etc. IMHO, there is no one to blame if you are "blindsided" by
your residency
choice. Use an elective, talk to an attending, do something. Frankly, proclaiming ignorance and mistake in decision should be embarassing.
In the end, wether you choose a career in medicine, lawyer, Vet, engineer, school teacher, etc... you choose and there are consequences seen and unseen to every choice.